Impact of the COVID-19 pandemic on the performance of endoscopy in the Tohoku region of Japan

Objectives: The whole picture of the disturbance in endoscopy performance caused by the coronavirus disease 2019 (COVID-19) pandemic in Japan remains to be clarified. Therefore, the Japan Gastroenterological Endoscopy Society-Tohoku conducted this questionnaire survey in Tohoku region of Japan. Methods: A questionnaire on the number of diagnostic endoscopy procedures and resulting diagnosed cancers in 2019 and 2020 was sent to all guidance/guidance cooperation hospitals in the Japan Gastroenterological Endoscopy Society who worked in the Tohoku region. The percentage change was calculated by comparing the numbers in 2020 with those in 2019 (the pre-COVID-19 period). Results: Among the applicable 89 guidance/guidance cooperation hospitals, 83 (94%) returned the questionnaire. The number of endoscopy procedures promptly decreased to the nadir in April and May 2020 (during the first state of emergency in Japan);however, it recovered relatively quickly, within a few months after the state of emergency was lifted. Consequently, the annual reduction in the number of endoscopy procedures in 2020 (in comparison to 2019) was 10.1% for esophagogastroduodenoscopy and 7.9% for colonoscopy. The reduction in the number of diagnostic endoscopy procedures led to a 5.5% reduction in esophagogastric cancer and 2.7% in colorectal cancer. Conclusions: This is the most comprehensive survey on the impact of the COVID-19 pandemic on the performance of endoscopy and the resulting diagnosis of cancer in Japan. Understanding the magnitude of the decline in endoscopic examinations and cancer detection due to the pandemic is critical to understanding how many people will ultimately be affected and establishing a strategy for providing endoscopy during national emergencies. Copyright © 2023 The Authors. DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.

TYPES OF ATTENDEES IN COMMUNITY SPACE IN JAPAN: TOWARD DESIGNING AN ENVIRONMENT FOR SOCIAL PARTICIPATION

Introduction: Designing community space for social participation of older adults is essential for healthy aging. The behavioral characteristics of the attendees have much to offer as they relate to social settings designed in the space. This study aims to elucidate the basic typology of the attendees considering their motivation for attendance and state of social connection. Methods: Semi-structured interviews targeting attendees of Chiiki-Katsudokan, a space designed for social participation in a larger aging estate in Japan, were conducted in December 2021 (N=16, 16% male). Attendees were asked about their reasons for attending events at Chiiki-Katsudokan, interaction levels with other attendees, and levels of social participation during the COVID-19 pandemic. Results: Based on the interviews, attendees were classified into three types: Seeker, Hobbyist, and Socializer. First, Seekers (n=3) used Chiiki-Katsudokan as the primary means of preventing social isolation. Amongst the three types, the social interaction level of Seekers was the lightest, and the opportunity decreased when Chiiki-Katsudokan closed during the quarantine. Second, the main motivation for Hobbyists (n=5) was the event contents which matched their interests. Hobbyists were also likely to engage in hobby networks, which continued privately during the pandemic. Finally, Socializers (n=8) attended Chiiki-Katsudokan to communicate with friends. Many were initially socially active and engaged in social interaction outside Chiiki-Katsudokan, e.g., teatime with friends, during the quarantine. Conclusion: This study suggested that designing community space for social participation requires defining the varying levels of engagement and expecting relationships outside the space based on the behavioral characteristics of the attendees.

SOCIAL INTERACTIONS OF COMMUNITY SPACE ATTENDEES AND ANTICIPATED FUNCTION OF THE SPACE AMID THE COVID-19 PANDEMIC

Introduction: A regional community space in Japan, Chiiki-Katsudokan, was founded to facilitate the social interactions of older adults through activities. Meanwhile, the COVID-19 pandemic occasionally forced this space to close or limited the volume of its participants. In this research, the operation of the space was reviewed by monitoring the changes in the social interactions of the attendees, and by investigating the anticipated function from the attendees' needs. Method: A semi-structured interview targeting the attendees of Chiiki-Katsudokan was conducted in December 2021 (N=19, main age:80s). The level of social interaction before and during the pandemic and the newly anticipated function of the space were examined. Results: First, deep and light interactions were observed. Those with deep interactions initially had wide social connections and used Chiiki-Katsudokan to interact with friends. Meanwhile, those with light interactions only talked to other attendees while attending the space. During the quarantine, those with deep interactions stayed connected with others and met privately, while those with light interactions faced a higher risk of social isolation. Second, the most popular newly anticipated functions of the space were "Place to gather with friends (n=14)" and "Interaction with younger generation (n=14)." "Opportunity to learn about the new pandemic-lifestyle (n=11)" was also rated high, while need for "online events" was rated the lowest (n=7). Conclusion: The pandemic re-emphasized older adults' need for direct interaction. Low interest in technology-based countermeasures suggested that community spaces should expand their operation method while considering offline methods (e.g., pen-pal system) that could enhance social interaction.

Poor Health Behaviors among Housebound Japanese Community-Dwelling Older Adults Due to Prolonged Self-Restraint during the First COVID-19 Pandemic: A Cross-Sectional Survey.

BACKGROUND: Prolonged self-restraining behaviors induced by the coronavirus disease 2019 (COVID-19) pandemic's containment measures can limit various positive health behaviors. OBJECTIVE: We examined the decline in going-out and certain other positive health behaviors and investigated the relationship between excessive decreases in going-out frequency and declining engagement in positive health behaviors among community-dwelling older adults during the self-restraint period. DESIGN: This study employed a cross-sectional survey design. SETTING: This study was conducted in Nishi Tokyo City, Tokyo, Japan. PARTICIPANTS: The participants were 294 respondents (150 women) aged 50 years and older who lived in public housing that were permitted to be surveyed during the self-restraint period. MEASUREMENTS: Their pre-pandemic going-out frequency around February 2020 and going-out frequency during the self-restraint period starting in April 2020 were reported. We mainly assessed the existence of home health behaviors (i.e., exercise, in-person and phone conversations, and healthy diet). A self-report questionnaire was used to obtain data. RESULTS: Going-out frequency decreased in 41.2% of the 294 respondents owing to the government's request for self-restraint. In total, 13 individuals had been going out less than one time per week (housebound) before the request. Of the 281 people who were not housebound before the government's self-restraint request, 13.9% were newly housebound. Newly housebound individuals were 5.3 times less likely to exercise, had 2.1 times fewer social contacts, and 2.6 times less balanced or healthy diets than those who maintained their frequency of going out. CONCLUSIONS: Prolonged self-restraint due to the COVID-19 pandemic may lead to housebound status and poor health behaviors. Public health intervention is needed to prevent excessive self-restraint, along with new measures integrating information and communication technologies to enable older adults to live active lives.

Social Detachment Influenced Muscle Mass and Strength during the COVID-19 Pandemic in Japanese Community-Dwelling Older Women.

Social detachment due to coronavirus disease (COVID-19) has caused a decline in physical activity, leading to sarcopenia and frailty in older adults. This study aimed to compare muscle mass, strength, and function values in older women before and after the first wave of the COVID-19 pandemic (April-May 2020). Furthermore, changes in muscle measures across women who experienced different levels of impact on their social participation due to the COVID-19 pandemic were examined. Muscle mass (total, trunk, and appendicular muscle), grip strength, oral motor skills, social interactions (social network and participation), and social support were assessed in 46 Japanese community-dwelling older women (mean, 77.5 y; range 66-93 y) before and after the first wave of the COVID-19 pandemic. Trunk muscle mass significantly decreased after the first wave of the pandemic. When comparing changed values between the enhanced/maintained and reduced group during the pandemic, significant group difference was observed in trunk muscular mass, grip strength, and oral motor skills. Intriguingly, those who enhanced social participation had a positive change of grip strength values, showing that social participation might influence muscle function during the COVID-19 pandemic.